Organization
YUMA PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA FAYE TUDOR (OFFICE MANAGER)
(928) 344-4800
Entity
Organization
Contact information
Practice address
2359 22ND DRIVE, SUITE 2, YUMA, AZ 85364
(928) 344-4800
(928) 726-2377
Mailing address
2359 22ND DRIVE, SUITE 2, YUMA, AZ 85364
(928) 344-4800
(928) 726-2377
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
AZ22611
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186082 02
—
AZ
01
—
AZ0715400
BCBC
AZ
Enumeration date
12/11/2006
Last updated
08/22/2020
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